2021 GCR Registration

Please choose Event. May choose more than one if attending. *
Current Total:
0.00

Attendee Information

 +

Parent/Guardian

Relationship to Participants: *
 

Medical

Who to contact in case of emergency

CONSENT AND RELEASE FORM FOR CAMPERS AT GREENBRIER CHRISTIAN RETREAT

I, the undersigned parent or guardian, hereby consent to my child listed on this form, participating in the activities connected with the trip to and from and the time at the Greenbrier Christian Retreat in Crawley, West Virginia. I certify that my child is able to participate in the activities (unless otherwise indicated). If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them on the registration form. There are no medical facilities on site at Greenbrier Christian Retreat. I hereby authorize the adult sponsors to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in I have listed them on the registration form. I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do hereby agree to hold Greenbrier Christian Retreat, volunteers, board members, agents and employees harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity of participation in any other associated activities. I also grant Greenbrier Christian Retreat and Camp representatives and employees the right to take photographs/videos of my child/children while they are at camp. I authorize Greenbrier Christian Retreat, Camp assignees and transferees to copyright, use and publish the same in print and/or electronically. I agree that Greenbrier Christian Retreat may use such photographs/videos with or without my child/children’s name for any lawful purposes, including for example such purpose as publicity, illustration, advertising and web content. I expressly agree that this release, waiver and indemnity agreement is intended to be broad and inclusive as permitted by law of the State of West Virginia and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect. This release contains the entire agreement between the parties hereto, and the terms of this release are contractual and not a mere recital. ALL RIGHTS OF VENUE WILL BE HELD IN GREENBRIER COUNTY, WEST VIRGINIA. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand. By Signing below I am submitting my child that I am legally in charge, to the rules and guidelines of Greenbrier Christian Retreat. I understand at the time of signing I am not under the influence of any drug or alcohol and am in complete understanding of the agreement that I am signing. *
clear

CAMPER / Attendee Guideline and Hold Harmless Agreement: (Parents or Guardians must sign this section representing Camper Attendee)

As a Camper/ Attendee I understand that I will abide by the rules and guidelines of Greenbrier Christian Retreat. I will submit to the authority of the camp Directors, Councilors, and Leaders of Greenbrier Christian Retreat as they work to maintain guidelines in line with Greenbrier Christian Retreat. I understand that Greenbrier leadership can at any time ask me to leave due to improper conduct. At that time parents or guardians will be called to pick me up in the event that I am involved with improper conduct. I also understand as an Camper (Attendee) that I will not bring any alcoholic beverages, Weapons of any nature, Electronic devices, or printed material not in line with the guidelines or rules of Greenbrier Christian Retreat. I also understand at some time during my stay that I may be included in marketing material used to promote camp. I give full permission to use my image for the marketing purposes of the camp. I will refrain from improper language and will at the best of my ability behave in a godly manner. Hold Harmless COVID 19 GREENBRIER CHRISTIAN RETREAT HOLD HARMLESS LETTER RENTAL GROUPS/INDIVIDUALS REGARDING COVID-19 THIS LETTER IS AN ACKNOWLEDGEMENT BY ANY GROUP/INDIVIDUALS USING, RENTING OR ATTENDING GREENBRIER CHRISTIAN RETREAT THAT GREENBRIER CHRISTIAN RETREAT OR ITS BOARD OF DIRECTORS HAVE NO LIABILITY REGARDING COVID-19. IT IS THE RESPONSIBILITY OF ATTENDING GROUPS TO ADHERE TO THE STATE MANDATED GUIDELINES REGARDING ALL PRECAUTIONS PERTAINING TO COVID-19 AND ITS CONTACT AND SPREAD. BY SIGNING THIS AGREEMENT THE ATTENDING PARTY ACKNOWLEDGES THEY ARE PRACTIING THE STATE/COUNTY GUIDELINES. By signing this agreement all parties involved as an Individual or with my group will adhere to the GCR guidelines and understand that my group or myself will be responsible for any damages that is caused by my group. *
clear